Paediatric narcolepsy: complexities of diagnosis.

Narcolepsy is a sleep disorder that is characterized by excessive daytime sleepiness and the inappropriate intrusion of aspects of rapid eye movement sleep into wakefulness. While the disorder emerges from an interplay of genetic and environmental factors, recent findings suggest that abnormalities in the neurotransmission of hypocretin may be implicated in its pathogenesis. Although narcolepsy has typically been associated with adulthood, there is a growing evidence base for the emergence of the disorder in childhood. We report suspected narcolepsy in early infancy, highlighting both the complexities of presentation and subsequent diagnosis associated with paediatric narcolepsy, and the significant psychosocial difficulties experienced by children and families managing this disorder.

Believing what you feel: using proprioceptive feedback to reduce unilateral neglect.

Unilateral spatial neglect declines when participants reach to grip the center of long metal rods compared with when they point to the perceived center, suggesting that visuomotor control systems are less affected by neglect than other representational systems (I. H. Robertson, D. Nico, & B. Hood, 1995). In this study, 16 participants with unilateral left neglect actually picked up rods, and we predicted short-term improvements in neglect because of induced conflict between a phenomenally symmetrical visual world on the one hand and a proprioceptively conveyed rightward-biased world on the other. With participants serving as their own controls, significant short-term improvements in neglect were found on 2 out of 4 neglect tasks after participants experienced proprioceptive feedback discrepant from the judgments they made on the basis of visual information alone.

The intention to act improves unilateral left neglect: two demonstrations.

Unilateral neglect involves a spatial bias to one side of space, usually to the right. Perceptual and motor systems interact in the manifestation of this disorder, and there is also evidence that motor manipulative responses may have access to unique streams of information not available for non-motoric judgements. It is therefore predicted that the manifestation of neglect may be alterable by changing the purpose of otherwise very similar responses to spatially extended objects. In Experiment 1, neglect-based deviation to the right of centre was significantly less when subjects reached towards metal rods as if to pick them up in the centre, compared to when they pointed to their centres. In Experiment 2, subjects pointed to the centre of a rectangular box with a swivelled lid. They were then asked to place a coin at the centre of this lid, in a position sufficiently central to prevent the lid tilting and the coin falling into the box; in fact, the lid was fixed and subjects never received feedback. Responses were significantly more central with the balancing response than with the pointing one. These results suggest that prehensive movements towards objects allow 'leakage' of information about their spatial extent, via an unaffected stream of information available for motor-manipulative responses.

The relationship between cognitive failures, psychoneurotic symptoms and sex.

As Broadbent et al's (1) original analysis of the relationship between the Cognitive Failures Questionnaire (CFQ) and the Middlesex Hospital Questionnaire (MHQ) was conducted on an altered version of the MHQ, the present study undertook this same analysis using the full MHQ. In addition, the relationship was examined to see if it was mediated by the differences in the scoring of males and females on each questionnaire. Our results support and strengthen Broadbent et al's conclusion that high rates of cognitive failure are associated with psychoneurotic symptoms. The sex difference on the CFQ is discussed in terms of vulnerability to stress to account for the higher incidence of psychoneurotic symptoms in females.